Men are four times more likely to die by suicide than women and the highest risk group is among those aged 45-54, researchers have found.

It also found that farmers and people living in rural isolation are among the groups most vulnerable.

The report from Men's Health Forum in Ireland and the HSE was launched by former Republic of Ireland international Jason McAteer.

‘You are not able to make the farm perform’

The consensus in the report from both middle-aged men and service providers was that particular transitions at middle-age pose a unique set of challenges for middle-aged men.

For many of the men, the deterioration of one’s physical health brought about through ageing, illness or injury had significant knock-on implications in terms of psychological distress.

Physical changes, a propensity to gain weight, a ‘slowing down’ effect, and reduced capabilities to carry out habitual tasks, were repeatedly cited as sources of torment and frustration for middle-aged men.

The latter, was particularly troublesome for middle-aged men working as farmers, as declining health resulted in declining work productivity and, thus, more financial strain.

This reduced capacity to ‘perform’, embodied in an ailing physical body, is captured by one farmer James who said "...if your physical health deteriorates, and you are not able to do the things that you think you should be able to do, then that obviously affects you mentally… you are not able to make the farm perform as well as it could…’’ James, Farmer

Financial pressure on the farmer

Middle-age is a time that all participants associated with increased responsibility and financial pressures, both of which were perceived to be potential sources of significant psychological distress.

This was particularly evident among fathers, when faced with situations in which their perceived role of provider was undermined. Impending bills, loans, mortgages, and children going to college were reported as financial burdens that tended to be felt most acutely by this age cohort.

“It puts a financial pressure on the farmer as well. If you have two or three in college at the one time, you are trying to make a living, you are trying to keep them in college, you are trying to save money for a bit of a pension. So it is a juggling act”.

‘We would see it as a failure’

Service providers also reported that men had a tendency to be heavily self critical when they ‘failed’ in their role as provider, irrespective of whether the issue was within or beyond their control.

James, a farmer, also reflected on how he perceived men to internalise ‘failures’ outside of their control, such as a family member not taking up the option of making their livelihood from the farm.

‘’Within men we are good at internalising it all - well I have failed. We would see it as a failure if we haven’t been able to make it attractive enough for the next person to stay there”. James.

'You feel left behind'

Throughout the past number of decades, Ireland has undergone huge economic growth and subsequent economic recession.

Whilst this, and the pace of societal change more generally, has thrown up challenges for all, the findings from this study suggest that these changes have posed particular challenges for middle-aged men.

Other societal challenges, such as the changing role of men, temporary employment contracts, multiple career paths, the decline in the influence of the Church, and the demise of rural communities have resulted in middle-aged men, in particular, feeling somewhat left behind in society:

“Life has moved at a very fast rate and you feel left behind,’’ Fred, Farmer.

Some farmers and rural isolated men felt that their communities had simply been ‘left behind’ and forgotten about.

Vacant units and the closure of businesses in rural Ireland were highlighted as visible scars of recession and as embodying the dearth of opportunities in these areas ‘’…it always seems that we (West of Ireland) get left behind. It just gets accelerated with this recession.

'Dublin has picked up and has moved on, but there is nothing happening down here'

“Dublin has picked up and has moved on, but there is nothing happening down here...It always seems every time something happens the West seems to get left further behind,” said Mike, Rural Isolated Man.

Beyond the pub, rural men felt that sporting events and the church were the only remaining social fabrics within their communities.

‘’There is the death of the whole rural community… That means if you are left there (rural Ireland) there are less social interactions. The community is gone real low. In this greater area, you have a false community of people who work in Dublin and live out here. They don’t get involved in the community’’. James, Farmer

The closure of rural pubs, and the increased restrictions posed by drink driving laws, was also perceived to increase levels of isolation among middle-aged men in rural Ireland.

Although these men agreed in principle with the new restrictions on drink driving, they highlighted how the pub was the only social outlet for many middle-aged men in their community and that there were no alternative means of socialising:

"I am not saying you should drink and drive, but there are a lot of farmers out there that that is their only social outlet. That is not happening now… The bit of slagging is not there anymore. So we are coming into a generation where the social outlet is going to have to change, but at the moment there is none - we are at a transition between no pubs and something else’’. Fred, Farmer

Dr Noel Richardson, of the Institute of Technology Carlow and co-author of the report, said that particular risk factors which were identified include increased psychological distress among more marginalised groups of middle-aged men.

It could be due to mid-life changes, decreasing life and career opportunities, unfulfilled aspirations and expectations and poorer physical health.

They may also find it difficult to cope with increasing pressures of middle age and rejection or isolation.

He said: "The hope or expectation for finding a magic formula that will be the panacea for addressing the higher suicide rates among middle-aged men is not realistic."

Dr Richardson suggested the report's recommendations could provide a road map to address the issues and challenges that had been raised.

"It behoves all stakeholders to mobilise the will and commitment to translate these [recommendations] into tangible outcomes," he added.

The report proposes more effective and gender-specific programmes, services, and resources that support the mental health and well-being of middle-aged men.

These recommendations cover six key areas: advocacy, connection, communication, education and training, stigma reduction and awareness, and support. It said that together these recommendations aimed to reduce the risk of suicide in particular groups of middle-aged men.

The HSE's National Office for Suicide Prevention is to work with and support the Men's Health Forum in Ireland in moving to the next phase, of implementing a number of the strategic recommendations.

If you have been affected by any issues raised in this article, please contact The Samaritans free helpline on 116 123.